Ureteroscopic endopyelotomy at a single setting.
OBJECTIVE
Endopyelotomy has become the initial treatment of choice for ureteropelvic junction obstruction. Debate persists regarding the preferred approach (percutaneous or ureteroscopic) and the need for preoperative stenting. We review our experience with ureteroscopic endopyelotomy without preoperative stenting.


METHODS
We treated 21 patients a mean of 37 years old who had ureteropelvic junction obstruction with ureteroscopy and without preoperative stenting. Endoluminal ultrasound was performed in all cases for imaging the periureteral anatomy. A minimum of 1 year of followup is available in all cases. Success was defined as pain-free status with resolution of obstruction on diuretic renal scintigraphy.


RESULTS
Success was achieved in 17 of 21 patients (81%). Complications included stent irritation, postoperative urinary tract infection and stent displacement requiring repositioning in 1 case each. Crossing vessels in 57% of the patients affected success (67 versus 100% in those with and without crossing vessels, respectively). No patient had significant hemorrhage.


CONCLUSIONS
Ureteroscopic endopyelotomy without preoperative stenting is effective and safe for ureteropelvic junction obstruction.
Conlin
M J
MJ
Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Bagley
D H
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014513:Ureter / Q000000981:diagnostic imaging; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D018666:Ureteroscopy; D014546:Urinary Catheterization